The long-term goal of this project is to understand how age of identification (before 6 mo, between 12 & 18 mo, or between 24 & 30 mo) and communication mode (spoken-only or sign-supplemented) affect spoken language, cognitive, and psychosocial development in young children (under 5 years) with hearing loss (HL). The coincidental advent of effective procedures for diagnosing HL in newborns and of cochlear implants has spurred the general perspective that virtually all children with HL can develop good spoken language, but we don't yet agree on how best to facilitate that development, nor do we know whether there is a "cost" to cognitive and/or psychosocial development imposed by early diagnosis or intervention. To advance our knowledge concerning these issues 25 children in each of 6 cells (crossing 3 ages of identification and 2 communication modes) as well as 50 children with normal hearing (NH) would participate in 5 to 8 test sessions, depending on age of identification. Materials collected would include samples of parent-child interactions, standardized language and cognitive measures, and responses to parental questionnaires. The kinds of data derived from these materials would be new to the study of HL but would reflect current methods used in the study of children with NH, and would include measures of speech acoustics, vocabulary, syntax, discourse, nonverbal cognitive abilities, psychosocial development, and parental stress. Results will help the community of professionals serving children with HL in designing intervention programs and in selecting tools to evaluate progress.